Although rare, neurovascular injuries are major complications. The purpose of this study was to use cadaveric dissection to determine the proximity of medial and lateral meniscus repair to major neurovascular structures in the posterior knee. We hypothesized that repair of the posterior horn of the medial and lateral menisci would be within 1 centimeter proximity of a key neurovascular structure.
The study was performed on 4 fresh-frozen cadaveric specimens that included the full knee joint spanning from the distal femur to proximal tibia and fibula. Following identification and tagging of the key structures, arthroscopic meniscus repair was simulated using Arthrex Fiberstitch 12o curved set to the max depth of 18mm from both portal sites at various meniscus locations. Fluoroscopy was used to measure the distance from the tip of the repair device to the various tagged neurovascular structures.
On average, a lateral portal entry to the posterior horn of the lateral meniscus was in closest proximity to the common peroneal nerve and popliteal artery, with distances of 13.6 mm and 16.5 mm respectively. A lateral portal entry to the root of the lateral meniscus was in closest proximity to the tibial nerve, with an average distance of 15.7 mm. A lateral portal entry to the body of the medial meniscus had the longest average distances to the common peroneal nerve, popliteal artery, and tibial nerve.
